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Diet and hip fractures among elderly Europeans in the EPIC cohort

European Journal of Clinical Nutrition volume 65, pages 132–139 (2011)Cite this article

Subjects

Abstract

Background/Objectives:

Evidence on the role of diet during adulthood and beyond on fracture occurrence is limited. We investigated diet and hip fracture incidence in a population of elderly Europeans, participants in the European Prospective Investigation into Cancer and nutrition study.

Subjects/Methods:

29 122 volunteers (10 538 men, 18 584 women) aged 60 years and above (mean age: 64.3) from five countries were followed up for a median of 8 years and 275 incident hip fractures (222 women and 53 men) were recorded. Diet was assessed at baseline through validated dietary questionnaires. Data were analyzed through Cox proportional-hazards regression with adjustment for potential confounders.

Results:

No food group or nutrient was significantly associated with hip fracture occurrence. There were suggestive inverse associations, however, with vegetable consumption (hazard ratio (HR) per increasing sex-specific quintile: 0.93, 95% confidence interval (CI): 0.85–1.01), fish consumption (HR per increasing sex-specific quintile: 0.93, 95% CI: 0.85–1.02) and polyunsaturated lipid intake (HR per increasing sex-specific quintile: 0.92, 95% CI: 0.82–1.02), whereas saturated lipid intake was positively associated with hip fracture risk (HR per increasing sex-specific quintile: 1.13, 95% CI: 0.99–1.29). Consumption of dairy products did not appear to influence the risk (HR per increasing sex-specific quintile: 1.02, 95% CI: 0.93–1.12).

Conclusions:

In a prospective study of the elderly, diet, including consumption of dairy products, alcohol and vitamin D, did not appear to play a major role in hip fracture incidence. There is however, weak and statistically non-significant evidence that vegetable and fish consumption and intake of polyunsaturated lipids may have a beneficial, whereas saturated lipid intake a detrimental effect.

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Acknowledgements

EPIC Elderly Network on Aging and Health has received funding from the Community (Directorate-General SANCO: Directorate C-Public Health and Risk Assessment, Grant agreement number: 2004126). Sole responsibility lies with the authors and the Commission is not responsible for any use that may be made of the information contained herein. The EPIC study was funded by ‘Europe Against Cancer’ Program of the European Commission (SANCO); German Cancer Aid; German Cancer Research Center; German Federal Ministry of Education and Research; Greek Ministry of Health; Stavros Niarchos Foundation; Hellenic Health Foundation; Italian Association for Research on Cancer; Italian National Research Council; Dutch Prevention Funds; LK Research Funds; Dutch ZON (Zorg Onderzoek, Nederland); World Cancer Research Fund (WCRF); Swedish Cancer Society; Swedish Scientific Council; Regional Government of Skane, Sweden.

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Authors and Affiliations

  1. Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece

    V Benetou, P Orfanos, D Zylis & A Trichopoulou

  2. Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    S Sieri

  3. Cancer Registry and Environmental Epidemiology Division, National Cancer Institute of Milan, Milan, Italy

    P Contiero

  4. Cancer Registry, ‘Civile - M.P.Arezzo’ Hospital, Ragusa, Italy

    R Tumino & M C Giurdanella

  5. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, GA Utrecht, The Netherlands

    P H M Peeters

  6. Helmholtz Zentrum M,

    J Linseisen

  7. ü,

    J Linseisen

  8. nchen, Institute of Epidemiology, Neuherberg, Germany

    J Linseisen

  9. Division of Cancer Epidemiology, German Cancer Research Centre, Unit of Nutritional Epidemiology, Heidelberg, Germany

    J Linseisen

  10. Division of Cancer Epidemiology, German Cancer Research Center, Molecular Tumor Epidemiology, Heidelberg, Germany

    A Nieters

  11. Centre of Chronic Immunodeficiency, CCI Molecular Epidemiology, University Medical Center Freiburg, Freiburg, Germany

    A Nieters

  12. Department of Epidemiology, German Institute of Human Nutrition, Bergholz-Rehbrücke, Germany

    H Boeing & C Weikert

  13. Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology, Umeå University, Umeå, Sweden

    U Pettersson

  14. Department of Odontology, Umeå University, Umeå, Sweden

    I Johansson

  15. National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands

    H B Bueno-de-Mesquita

  16. Public Health Division of Gipuzkoa, Health Department of Basque Government and Ciberesp, San Sebastian, Spain,

    M Dorronsoro

  17. Genetic and Epidemiology Cluster, International Agency for Research on Cancer, Lyon, France

    P Boffetta

  18. Hellenic Health Foundation, Athens, Greece

    P Boffetta & A Trichopoulou

  19. Mount Sinai School of Medicine, New York, NY, USA

    P Boffetta

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  1. V Benetou
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  2. P Orfanos
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Correspondence to V Benetou.

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Benetou, V., Orfanos, P., Zylis, D. et al. Diet and hip fractures among elderly Europeans in the EPIC cohort. Eur J Clin Nutr 65, 132–139 (2011). https://doi.org/10.1038/ejcn.2010.226

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